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General NPI Number Information
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NPI Number | 1245707462
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Entity Type | Organization
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Legal Business Name | SJZ18 LLC
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Dates
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Enumeration Date | 10/25/2018
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Last Update Date | 01/20/2019
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Provider Practice Location Address
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Address Line | 12651 W SUNRISE BLVD STE 102
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-888-8355
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Fax |
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Provider Business Mailing Address
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Address Line | 12651 W SUNRISE BLVD STE 102
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-888-8355
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. SHERYL ZAYAS
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Credential | DO
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Telephone | 305-794-1967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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